Progressive conscious control of scapular orientation with video feedback has improvement in muscle balance ratio in patients with scapular dyskinesis: a randomized controlled trial

Huang, Tsung-Hui; Du, Wan-Yu; Wang, Tyng-Guey; Tsai, Yung-Shen; Yang, Jing-Lan; Huang, Chien-Lan; Lin, Jiu-Jenq

doi:10.1016/j.jse.2018.04.006

Cited by 15 publications

(20 citation statements)

References 24 publications

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“…Similar to our findings, Huang and his colleagues have reported that motor control intervention by progressive conscious control scapular orientation with arm movement could immediately restore intramuscular ratio in patients with clinical shoulder impingement [31]. In addition, enhanced muscle recruitments and duration of activation of SA muscle were identified in patients with clinical shoulder impingement after a 12-week motor control intervention [30].…”

Section: Scapular Muscle Activationssupporting

confidence: 89%

“…It has been proposed that strengthening exercise has positive effect on regaining scapular muscle balance for scapular dyskinesis [ 26 – 29 ]. Furthermore, recent studies suggested motor control intervention is beneficial to restore scapular muscle balance by improving muscle recruitment pattern and scapular alignment with altering neurophysiological and biomechanical effects [ 30 , 31 ]. The motor control techniques, such as palpation, manual contact, verbal cues or visual feedback, have been used to restore neuromuscular control [ 30 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Motor control integrated into muscle strengthening exercises has more effects on scapular muscle activities and joint range of motion before initiation of radiotherapy in oral cancer survivors with neck dissection: A randomized controlled trial

et al. 2020

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Background Accessory nerve shoulder dysfunction is common after neck dissection in oral cancer survivors. This study aimed to investigate the short-term effects of scapular muscle strengthening exercises with motor-control techniques on neck dissection-related shoulder dysfunction in oral cancer survivors before the initiation of radiotherapy. Methods Thirty-eight participants were randomly allocated into the motor-control and regular-exercise groups. Each group received conventional physical therapy and specific scapular muscle strengthening exercises for 1 month immediately after neck dissection. Motor control techniques were integrated with scapular strengthening exercises for the motor-control group. Shoulder pain, active range of motion (AROM) of shoulder abduction, and scapular muscle activities including upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) when performing maximal voluntary isometric contraction (MVIC) and scapular muscle exercises were evaluated at baseline and after 1 month of training. Results Both groups reduced shoulder pain and increased muscle activity of maximum voluntary isometric contraction (MVIC) of each muscle after the intervention. Increased AROM of shoulder abduction was only observed in the motor-control group (95% CI 3.80 to 20.51, p = 0.004). Relative to baseline evaluation, muscle activities of UT decreased in the motor-control group when performing shoulder shrug with 1-kg weight (95% CI-33.06 to-1.29, p = 0.034). Moreover, the SA activity decreased in the motor-control group (95% CI-29.73 to

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Section: Scapular Muscle Activationssupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Motor control integrated into muscle strengthening exercises has more effects on scapular muscle activities and joint range of motion before initiation of radiotherapy in oral cancer survivors with neck dissection: A randomized controlled trial

et al. 2020

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“…Also, we did not consciously control scapular position, which may have influenced scapular muscle activity during elevation exercises in overhead athletes with subacromial impingement. 27 Another limitation is inherent to the use of surface EMG during dynamic exercises. Nevertheless, standard guidelines were strictly followed.…”

Section: Discussionmentioning

confidence: 99%

Incorporation of the Kinetic Chain Into Shoulder-Elevation Exercises: Does It Affect Scapular Muscle Activity?

Borms

Maenhout

Cools

2020

Journal of Athletic Training

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Context Scapular rehabilitation exercises should focus on selective activation of weaker muscles and minimal activation of hyperactive muscles. For rehabilitation of overhead athletes, single-plane open chain exercises below 90° of shoulder elevation are often recommended. Moreover, incorporating the kinetic chain in shoulder rehabilitation exercises is advised and has been suggested to influence scapular muscle activity levels. Objective To study the influence of kinetic chain incorporation during 5 variations of a shoulder-elevation exercise on scapular muscle activity. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Thirty-one asymptomatic participants (15 men, 16 women). Main Outcome Measure(s) The electromyographic activity of the upper (UT), middle (MT), and lower (LT) trapezius, and serratus anterior was determined during 5 variations of bilateral elevation with external rotation: (1) open-hand position (reference exercise), (2) closed-hand position, (3) dynamic bipedal squat, (4) static unipedal squat, and (5) dynamic unipedal squat on the contralateral leg. All data were normalized as a percentage of maximal voluntary isometric contraction (MVIC). Results A closed-hand position (exercise 2) instead of an open-hand position (exercise 1) resulted in lower MT (mean difference = 3.44% MVIC) and LT (mean difference = 7.76% MVIC) activity. Incorporating the lower limb (exercises 3–5) increased UT activity when compared with exercise 1 (mean differences = 3.67, 2.68, 5.02% MVIC, respectively), which in general resulted in increased UT : MT ratios. Additionally, LT activity decreased when a dynamic unipedal squat was added (mean difference: 4.90% MVIC). For the serratus anterior, the greatest activity occurred during elevation in a static unipedal squat position (exercise 4, 22.90% MVIC). Conclusions Incorporating the kinetic chain during shoulder-elevation exercises influenced scapular muscle activity and ratios. In particular, incorporating the lower limb resulted in more UT activity, whereas the open-hand position increased MT and LT activity.

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“…5 Some studies have reported the influence of conscious control of scapular orientation on scapular muscle activation during common shoulder training movements. 7,14,24 UT/MT and UT/LT activation ratios were significantly reduced with conscious control during arm elevation in the scapular plane. 24 Furthermore, a positive effect of conscious control of scapular orientation with or without video feedback was also reported to both reduce the UT/LT ratio and improve scapular internal rotation during arm elevation.…”

mentioning

confidence: 88%

“…24 Furthermore, a positive effect of conscious control of scapular orientation with or without video feedback was also reported to both reduce the UT/LT ratio and improve scapular internal rotation during arm elevation. 14 Therefore, conscious control of scapular orientation during arm movements can be used to control scapular movement and restore scapular muscle balance in patients with scapular dyskinesis.…”

mentioning

confidence: 99%

Clinical Factors Related to Improved Scapular Control After a Scapular Conscious Control Program in Symptomatic Overhead Athletes: Secondary Analysis of a Randomized Controlled Trial

Huang

Lin

2020

Orthopaedic Journal of Sports Medicine

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Background: Predictive variables associated with the effects of a scapular conscious control program should be identified and used to guide rehabilitation programs. Purpose: To determine whether potential factors are associated with the success of scapular muscle balance with an early control program in patients with subacromial pain and scapular dyskinesis. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 38 amateur overhead athletes with subacromial pain and medial border prominence were recruited. They performed progressive conscious control of scapular orientation during 45° and 90° of arm elevation. Stepwise logistic regression and receiver operating characteristic curve were used to determine the optimal cutoff point of related factors for success or failure of the program. Potential factors including pain level during activity, pain duration, anterior/posterior shoulder flexibility, forward shoulder posture, posterior displacement of root of spine and inferior angle, scapular kinematics, and muscle activation before conscious control program were recorded as independent variables. Successful control defined as decreases of the upper trapezius/serratus anterior ratio in 2 consecutive trials of the 90° program or failure in the program was used as a dependent variable. Results: Having a posterior displacement of the inferior angle of the scapula of ≤16.4 mm and scapular posterior tipping during arm elevation of ≤3.3° (collected before the control program) were associated with the success of the program ( R 2 = 0.286; P < .05). Additionally, participants with each or both variables present at baseline had probabilities of success of 78% and 95%, respectively. Conclusion: The value of scapular posterior displacement and posterior tilt should be considered before early scapular control program. Other factors related to the success of the program should be found due to the limited variance explained in the regression model.

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Progressive conscious control of scapular orientation with video feedback has improvement in muscle balance ratio in patients with scapular dyskinesis: a randomized controlled trial

Cited by 15 publications

References 24 publications

Motor control integrated into muscle strengthening exercises has more effects on scapular muscle activities and joint range of motion before initiation of radiotherapy in oral cancer survivors with neck dissection: A randomized controlled trial

Motor control integrated into muscle strengthening exercises has more effects on scapular muscle activities and joint range of motion before initiation of radiotherapy in oral cancer survivors with neck dissection: A randomized controlled trial

Incorporation of the Kinetic Chain Into Shoulder-Elevation Exercises: Does It Affect Scapular Muscle Activity?

Clinical Factors Related to Improved Scapular Control After a Scapular Conscious Control Program in Symptomatic Overhead Athletes: Secondary Analysis of a Randomized Controlled Trial

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